Pseudoseizures in children and adolescents with or without epilepsy

85 pts (34 ♂, 51 ♀, aged 5 1/2 -18 years) with seizures of uncertain epileptic origin were examined in the years from 1976 to 1987. The diagnostic method includes: accurate anamnesis, observation of the seizures by some experts; repeated EEG (standard, sleep-registration, telemetry, poligraphy, video-tape) with activation when necessary, heart examination and EKG. In 18% the EEG registration of the pseudo-seizures permitted a rapid diagnosis; in 70% the diagnostical iter was prolonged during the psychotherapeutic treatment; in 12% some doubts remained. 48 pts assumed AED and were considered to be resistant to therapy. 4 groups were singled out: 28 epileptic pts with epileptic seizures and pseudo-seizures; 39 pts with pure pseudo-seizures; 7 pts with syncopes; 11 pts with doubtful seizures (diagnostic uncertainty, between pure pseudo-seizures and combined with partial seizures). In the most immature pts, the somatisation appeared to be reactive to conflicts with the environment; short-term psychotherapy was successful. In adolescents with normal intelligence some forms of somatic conversion (a neurotic mechanism) were noticed; in these cases a long-term psychotherapy was necessary.